title: Arthroscopy-assisted reduction of posteromedial tibial plateau fractures with buttress plate and cannulated screw construct.
abstract: OBJECTIVE
  To present the radiologic and clinical results of posteromedial fractures treated with arthroscopy-assisted reduction and buttress plate and cannulated screw fixation.
  
  
  METHODS
  Twenty-five patients with posteromedial tibial plateau fractures treated by the described technique were included in this study. According to the Schatzker classification, there were 5 type IV fractures (20%), 2 type V fractures (8%), and 18 type VI fractures (72%). The mean age at operation was 46 years (range, 21 to 79 years). The mean follow-up period was 86 months (range, 60 to 108 months). Clinical and radiologic outcomes were scored by the Rasmussen system. Subjective data were collected to assess swelling, difficulty climbing stairs, joint stability, ability to work and participate in sports, and overall patient satisfaction with recovery. Secondary osteoarthritis was diagnosed when radiographs showed a narrowed joint space in the injured knee at follow-up in comparison with the films taken at the time of injury.
  
  
  RESULTS
  The mean postoperative Rasmussen clinical score was 25.9 (range, 18 to 29), and the mean radiologic score was 15.8 (range, 10 to 18). All 25 fractures achieved successful union, and 92% had good or excellent clinical and radiologic results. The 3 fracture types did not significantly differ in Rasmussen scores or rates of satisfactory results (P > .05). Secondary osteoarthritis was noted in 6 injured knees (24%).
  
  
  CONCLUSIONS
  Arthroscopy-assisted reduction with buttress plate and cannulated screw fixation can restore posteromedial tibial plateau fractures of the knee with well-documented radiographic healing, good clinical outcomes, and low complication rates.
  
  
  METHODS
  Level IV, therapeutic case series.
authors.affiliation: Department of Orthopaedic Surgery, Division of Sports Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Chih-Hao
authors.initials: CH
authors.lastname: Chiu
authors.forename: Chun-Ying
authors.initials: CY
authors.lastname: Cheng
authors.forename: Min-Chain
authors.initials: MC
authors.lastname: Tsai
authors.forename: Shih-Sheng
authors.initials: SS
authors.lastname: Chang
authors.forename: Alvin Chao-Yu
authors.initials: AC
authors.lastname: Chen
authors.forename: Yeung-Jen
authors.initials: YJ
authors.lastname: Chen
authors.forename: Yi-Sheng
authors.initials: YS
authors.lastname: Chan
mesh_terms: D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000009:adverse effects / Q000379:methods*; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D016268:Internal Fixators; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016059:Range of Motion, Articular; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult